| NPI | 1063830420 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: NY 293164) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 49986) |
| 207R00000X Internal Medicine (Licence: NY 293164) | |
| Enumeration Date | 2014-04-02 |
| Last Update Date | 2021-03-08 |